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concussion video

post #1 of 29
Thread Starter 

I know you're not supposed to laugh:

 

Interesting approach to the C-collar and backboard.  

post #2 of 29

Never Stop Exploring.

post #3 of 29

Wow, I don't know what hurt more.  My ego, face, back or my head.

post #4 of 29
Quote:
Originally Posted by Pete No. Idaho View Post

Wow, I don't know what hurt more.  My ego, face, back or my head.

 

But that's not you, right?

post #5 of 29
Thread Starter 
Quote:
Originally Posted by Pete No. Idaho View Post

Wow, I don't know what hurt more.  My ego, face, back or my head.

My left knee hurts a little.
post #6 of 29
Quote:
Originally Posted by LiquidFeet View Post

 

But that's not you, right?

   

Well er NO, but then again I wouldn't admit it if it was me-would I ?    How is that for good English?

post #7 of 29
Quote:
Originally Posted by Pete No. Idaho View Post

Quote:
Originally Posted by LiquidFeet View Post

 

But that's not you, right?

   

Well er NO, but then again, I wouldn't admit it if it were me. Would I ?    How is that for good English?

A little better now tongue.gif

post #8 of 29

If my staff members did such a shitty job of assessing and stabilizing a patient with an obvious concussion, AND they let someone film it, I would be looking for new patrollers.

post #9 of 29
Thread Starter 
Quote:
Originally Posted by bunion View Post

If my staff members did such a shitty job of assessing and stabilizing a patient with an obvious concussion, AND they let someone film it, I would be looking for new patrollers.
I'm not a hirer/firer but I have to agree - I was kind of...surprised.
post #10 of 29

Is it protocol to C-collar and spine board when transporting a skier after an injury?
 

Since he was conscious, with full mobility, and I'm assuming no deformity, tingling, numbness, etc.

post #11 of 29
Thread Starter 
Quote:
Originally Posted by jzamp View Post

Is it protocol to C-collar and spine board when transporting a skier after an injury?
 

Since he was conscious, with full mobility, and I'm assuming no deformity, tingling, numbness, etc.

 

Monday-morning q-backing: With that mechanism of injury and the altered mentation, I probably would have restricted spinal motion with immediate c-spine traction and c-collar and backboard asap.  It seemed like the responders took a long time to get to that point - the patient's unrestricted movement might have aggravated a possible c-spine injury.  

 

You can't rule out c-spine injury just because of consciousness (even assuming there wasn't a positive loss of consciousness), and the altered mentation indicate any patient's denial of numbness or tingling may not be reliable.  The video doesn't show any palpation of the patient, so that info's not available.

 

Taking pictures/video like that likely violates patient privacy, especially considering altered mentation (no patent consent).  

 

/Monday morning q-backing.  

post #12 of 29

BTW, I'm not trying to debate their evaluation, the video could have been shot after they already assessed him, I'm just curious of what ski patrol protocol is.
I thought I should made that clear...

post #13 of 29

Found this thread through my Youtube and thought I'd chime in... I'm the one in the video with the concussion.  It happened in the backcountry not on Alta Ski Resort.  We had built a jump in Grizzly Gulch, and the Alta Ski Patrol coincidentally happen to be skiing by just seconds after I slammed my face into my ski pole.  I don't know why they happened to be over there since it is on the opposite side of the canyon road, but I'm glad they were there to assist. 

post #14 of 29

Whipit, thanks for replying. Hope you healed up nicely from your freestyle moves.

 

I believe that Alta does some snowcat skiing up in GG and that is one possible reason they were skiing by.

 

In cases of a consciousness and a LOC of < 4x4 you need to perform a pretty full assessment and take the more conservative approach to stabilization and transport. Closed head injuries are nothing to F%^k around with.

 

I wasn't there, it appeared to be a nice enough day with a relaxed scene and eventually the patrollers got to the point of applying proper C-spine protection.

 

Perhaps Whipit can add some more context.

 

That said, any medic is crazy to allow filming of a patient while they are working on them.

 

I never cease to be astounded by what you can find on You-tube.

post #15 of 29

Welcome to EpicSki Whipit.  Glad you're okay. 

post #16 of 29
Thread Starter 
Yeah, glad to hear that you're okay Whipit. Especially your left knee...wink.gif
post #17 of 29

Thanks for the welcome and good wishes.  This actually happened in 2005.  I ended up tearing my left ACL and getting a few stitches but beyond that I was fine.  At the time my bro-in-law was always filming and making ski vids.  Apparently Alta Patrol didn't mind.  I don't know if things have changed since then.  

post #18 of 29
Thread Starter 
Quote:
Originally Posted by jzamp View Post

BTW, I'm not trying to debate their evaluation, the video could have been shot after they already assessed him, I'm just curious of what ski patrol protocol is.
I thought I should made that clear...

 

To answer the question: it depends.  The factors include the ski area's protocols, the level of licensure/capability/ability of the responders, the assessment (primary and secondary), the mechanism of injury, presence or lack of multiple injuries, the patient's history and input, any transportation issues, etc.  

 

Emphasizing that most of us weren't there and that we're just reacting to an edited, it's curious that they treated the laceration, then initiated spinal motion restriction procedures afterwards, but it's possible that there was some development or issue or protocol or factor that we don't know about that influenced the decision.  But I know that my patrol director would have some questions for me if I were one of the responders (as we saw with Bunion's response).  

 

As for filming, it can violate the patient's right to privacy as well as lead to harsh questions from patrol directors.  wink.gif

post #19 of 29
I thought you were questioning how they used the collar and board, which puzzled me because from the start I'm thinking what the hell, so he has a concussion and a laceration and they're letting him sit up and move around because what--he's funny? The only thing mobility demonstrates is that the spinal cord isn't damaged--yet. Maybe they'd already palpated the spine, but I'd have thought that in the circumstances you'd immobilize him anyway. Maybe they knew more than they showed, but I can't imagine what.

But that's just me. th_dunno-1[1].gif
post #20 of 29

Thank you Bob! that's what I thought, just wanted to make sure.

post #21 of 29
Quote:
Originally Posted by Bob Lee View Post

 

As for filming, it can violate the patient's right to privacy as well as lead to harsh questions from patrol directors.  wink.gif

 

I find this a very interesting question.  

 

As more and more video cameras become easier to use in these environments, it's no secret that more people will try to film rescue efforts.  If patrol directors don't already have a policy on this, they probably need to put one in place very quickly.  

 

Filming first responders is a really, really slippery slope (sorry, couldn't resist).  Bob, how would you handle this if you came up to a wreck - particularly one with at least the possibility of spinal or cranial injuries - and somebody was standing there filming your every move?  You probably can't very well ORDER the guy to stop filming, but there's a big can of worms that is potentially being opened up.  Ski injuries in particular are so often very nebulous. You've got cold weather, tons of clothing, and possible joint injuries that are often difficult to diagnose even when the patient is lying naked in the hospital after an MRI.  It just seems to completely open up first responders to lawyer second-guessing when there's a film version of everything they did (and didn't do).  

 

And THIS case becomes even more interesting because the patrollers weren't even responding to an inbounds accident.  They were more like Good Samaritans or SAR than official patrollers.

 

Whipit, I'm sorry about your knee but glad you didn't have anything worse. Thanks for joining in. 

post #22 of 29

How did this get on the internet?

 

Seems like an violation of privacy.  Not sure if HIPAA rules apply this early in the chain of medical care.

 

Epic should pull the video.


Edited by hirustler - 11/13/12 at 4:50pm
post #23 of 29
Quote:
Originally Posted by hirustler View Post

How did this get on the internet?

 

Seems like an violation of privacy.  Not sure if HIPAA rules apply this early in the chain of medical care.

 

Epic should pull the video.

The victim has posted in this thread.  The video was taken by his brother-in-law and - presumably - put on YouTube by either the victim or the brother-in-law.

 

Doesn't HIPAA only apply to health care providers and professionals giving out information without the patient's permission?

 

I can't see why Epic would delete the link.  Who's been harmed here?

post #24 of 29

The victim posted after the video had been up for a while.  I wonder how he felt when he saw himself in that shape for the whole world to see.

 

Are you sure the victim really posted this on Youtube?  Is that where you found it?  If so then the victim has every right to broadcast this. But at least in this forum, he wasn't the one broadcasting it.  

 

I think that if he doesn't want it posted here, it would be a really nice gesture for Epic to remove it.

 

And yes HIPAA applies to health care providers.  Are Ski Patrol in this category?  Even if they're not legally bound by HIPAA, it seems that for all practical purposes they're working as Health care providers. So if a patroller made the video, then it's release would be a privacy violation.

 

If his brother made the video and put it up on Youtube then I agree there's no violation.

post #25 of 29
Quote:
Originally Posted by Bob Peters View Post

Doesn't HIPAA only apply to health care providers and professionals giving out information without the patient's permission?

 

Yes.  

Since the patrollers are providing professional medical care, they could not post this video.  A brother-in-law can.

As far as barring filming, how would that go?  The patrollers can ask...even demand...that a bystander not film them, but what if said bystander refuses?  

I can just about guarantee the patrollers wouldn't be able to use force to stop him, so then what?  Hell, law enforcement officers typically can't even do that.

A right to privacy claim would be a stretch, since he's in a location where there's generally no expectation of privacy...except for HIPAA restrictions on medical responders, of course.

post #26 of 29
Thread Starter 
Quote:
Originally Posted by Bob Peters View Post

Filming first responders is a really, really slippery slope (sorry, couldn't resist).  Bob, how would you handle this if you came up to a wreck - particularly one with at least the possibility of spinal or cranial injuries - and somebody was standing there filming your every move?  You probably can't very well ORDER the guy to stop filming, but there's a big can of worms that is potentially being opened up.  Ski injuries in particular are so often very nebulous. You've got cold weather, tons of clothing, and possible joint injuries that are often difficult to diagnose even when the patient is lying naked in the hospital after an MRI.  It just seems to completely open up first responders to lawyer second-guessing when there's a film version of everything they did (and didn't do).  

Good question. I would ask the person to stop filming and explain that it possibly violates the patient's privacy. Then, whether they stopped or not, I would continue with my job and document any issues on the paperwork. That's about all you can do. I've been handling wrecks where the patient asked friends to take pictures or video "for Facebook" or whatever and others where parents took pictures of their kids. Again, not much you can do about it. Just do your job well.

Quote:
Originally Posted by hirustler View Post

The victim posted after the video had been up for a while.  I wonder how he felt when he saw himself in that shape for the whole world to see.

Are you sure the victim really posted this on Youtube?  Is that where you found it?  If so then the victim has every right to broadcast this. But at least in this forum, he wasn't the one broadcasting it.  

I think that if he doesn't want it posted here, it would be a really nice gesture for Epic to remove it.

And yes HIPAA applies to health care providers.  Are Ski Patrol in this category?  Even if they're not legally bound by HIPAA, it seems that for all practical purposes they're working as Health care providers. So if a patroller made the video, then it's release would be a privacy violation.

If his brother made the video and put it up on Youtube then I agree there's no violation.

Go back and re-read the thread carefully, including the injured guy's post. I wasn't the healthcare provider and I found the video on unofficialnetworks.com:
http://unofficialnetworks.com/head-injuries-funnyexcept-hen-110982/

So you can relax. Or ask YouTube to take down every video of an injury.
post #27 of 29
Quote:
Originally Posted by Bob Lee View Post



So you can relax. 

 

Can't relax, haven't skied yet.

post #28 of 29
Ah, now I see. popcorn.gif
post #29 of 29

hiruster,

Like I said earlier, This video was taken Feb 12th, 2005.  It, along with countless other clips that my bro-in-law took, have been on my computer for years.  I've just recently started posing them on Youtube for entertainment.  And I am the victim, so it was no surprise to me to see my concussion on youtube or any other site because I was the one that put it on youtube as a public video in the 1st place.  I appreciate the discussion and controversy it has caused.  Hopefully, in addition to being entertaining, it can in some way be educational.

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